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Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The staging of renal adenocarcinoma is carried out using the American Joint Committee on Cancer (AJCC) tumor node metastasis (TNM) system

T: primary tumour.

  • TX: primary tumour cannot be assessed.
  • T0: no evidence of primary tumour.
  • T1: tumour <7 cm in greatest dimension, limited to the kidney.
    • T1a: tumour 4 cm or less in greatest dimension, limited to the kidney.
    • T1b: tumour >4 cm but not more than 7 cm in greatest dimension.
  • T2: tumour >7 cm in greatest dimension, limited to the kidney.
    • T2a: tumour >7 cm in greatest dimension but equal or not more than 10 cm, limited to the kidney.
    • T2b: tumours >10 cm limited to the kidney.
  • T3: tumour extends into major veins or perinephric tissues, but not into the ipsilateral adrenal gland and not beyond Gerota's fascia
    • T3a: tumour grossly extends into the renal vein or its segmental (muscle-containing) branches, or tumour invades the perirenal and/or renal sinus (peripelvic) fat but not beyond Gerota's fascia.
    • T3b: tumour grossly extends into the vena cava below the diaphragm.
    • T3c: tumour grossly extends into vena cava or its wall above the diaphragm or invades the wall of the vena cava.
  • T4: tumour invades beyond Gerota's fascia (including contiguous extension into the ipsilateral adrenal gland).

N: regional lymph nodes.

  • NX: regional lymph nodes cannot be assessed.
  • N0: no regional lymph node metastasis.
  • N1: regional lymph node metastasis.

M: distant metastasis.

  • M0: no distant metastasis.
  • M1: distant metastasis.

TNM information is combined to assign an overall anatomic stage of I-IV, which correlates with prognosis.


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